Attention difficulties are common after neurological injury and can affect how a person scans information, stays focused, and completes everyday tasks. In adult rehabilitation settings, printable worksheets are often used to provide structured cognitive practice in a format that is easy to understand, low-prep, and repeatable.
This page covers the letter cancellation task — one of the most widely used visual scanning formats. You can download a free worksheet below, learn how the task works, and see how graded versions are typically used.
Download the free letter cancellation worksheet
Download the PDFFree for personal, educational, and session use. This sample is a moderate difficulty level with two target letters.
What is a letter cancellation task?
A letter cancellation task presents a grid of letters and asks the person to cross out every instance of a target letter — for example, every “B” and “V” — as quickly and accurately as possible while ignoring the rest. Working through the grid row by row engages visual scanning, selective attention, and sustained attention in a format that is easy to explain, easy to print, and easy to repeat.
Cancellation formats like this are widely used in rehabilitation settings because performance is easy to observe: skipped targets, crossed-out distractors, and drift from a systematic scanning pattern are all visible on the page. Each worksheet includes optional fields for completion time and error count when added structure is helpful.
Grading: from simple to complex
In practice, attention tasks are often most useful when they are graded rather than one-off. With letter cancellation, grading typically involves:
- one target letter versus two at once
- targets that look distinct versus targets that resemble the surrounding letters
- lower versus higher letter density on the page
- case-sensitive rules — for example, crossing out only the lowercase “i” and uppercase “Z”
- untimed versus timed completion, with or without error counts
This allows the task to better match the individual's needs, tolerance, and current level of performance — starting simple and building up, rather than jumping straight to the hardest version.
Who uses letter cancellation worksheets
- Occupational therapists and speech-language professionals
- Rehabilitation and community programs
- Educators working with adult learners
- Caregivers supporting cognitive practice at home
- Adults looking for structured, printable cognitive activities
All of our worksheets are designed to be adult-appropriate, visually clean, and easy to understand without unnecessary visual clutter.
The free worksheet above is a single moderate-level sample. If you want the full graded progression, our Letter Cancellation set includes 30 worksheets across basic (single letter), moderate (two letters), and complex (case-sensitive) levels with consistent formatting.
